Provider Demographics
NPI:1649260019
Name:GUARDIAN ANGEL AMBULANCE SERVICES, INC.
Entity type:Organization
Organization Name:GUARDIAN ANGEL AMBULANCE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:412-464-1000
Mailing Address - Street 1:411 W 8TH AVE
Mailing Address - Street 2:PO BOX 435
Mailing Address - City:WEST HOMESTEAD
Mailing Address - State:PA
Mailing Address - Zip Code:15120-1014
Mailing Address - Country:US
Mailing Address - Phone:412-464-1000
Mailing Address - Fax:412-462-9947
Practice Address - Street 1:411 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:WEST HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1014
Practice Address - Country:US
Practice Address - Phone:412-464-1000
Practice Address - Fax:412-462-9947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016844560004Medicaid
PA0016844560002Medicaid
PA200152Medicare ID - Type UnspecifiedPROVIDER NUMBER
PA0016844560004Medicaid